Epidermolysis Bullosa Acquisita (Brunsting-Perry Pemphigoid Variant) Localized to the Face and Diagnosed With Antigen Identification Using Skin Deficient in Type VII CollagenAsfour, Leila MBChB, BSc, MRCP*; Chong, Heung FRCPath†; Mee, John PhD‡; Groves, Richard MBBS, FRCP‡; Singh, Manuraj MBBS, MRCP, PhD, DipRCPath (Dermpath)*American Journal of Dermatopathology: July 2017 - Volume 39 - Issue 7 - p e90–e96 doi: 10.1097/DAD.0000000000000829 Extraordinary Case Report Abstract Author Information Abstract: Brunsting-Perry pemphigoid is defined as an autoimmune vesiculobullous eruption typically localized on the head and neck region with minimal or no mucosal involvement. The disease tends to run a chronic and recurrent course with residual scarring. Histological features are characterized by subepidermal bullae and linear IgG deposits at the dermo-epidermal junction. We report a case of a 46-year-old lady who presented with typical features of Brunsting-Perry pemphigoid. Autoantibodies to type VII collagen were identified by using recessive dystrophic epidermolysis bullosa skin which lacks type VII collagen in an indirect immunofluorescence assay. As a result, we diagnosed our patient as having the Brunsting-Perry pemphigoid variant of epidermolysis bullosa acquisita (EBA). This finding led us to review the literature on target antigens in Brunsting-Perry pemphigoid. Only 11 out of the 58 cases reported to date had target antigens identified. Interestingly, type VII collagen was the second most common target antigen/autoantibody (4 cases) detected after BP180 (5 cases). However, 2 further cases of EBA localized to the face with typical features of Brunsting-Perry pemphigoid were found in the literature. Although the target antigens are heterogeneous in Brunsting-Perry pemphigoid, a significant number of cases represent a clinical presentation of localized EBA. Departments of *Dermatology, and †Cellular Pathology, St George's University Hospital, London, United Kingdom; and ‡Department of Immunodermatology, St Thomas' Hospital, London, United Kingdom. Reprints: Manuraj Singh, Department of Dermatology, St George's University Hospital, Blackshaw Road, London SW17 0QT, United Kingdom (e-mail: masingh@doctors.org.uk). The authors declare no conflicts of interest. Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.